Objective: To evaluate the efficacy of femoral primary malignant bone tumors treated by limb salvage, with wide en bloc excision and reconstruction of the defect with recycled pasteurized autograft.
Methods: From January 2008 to January 2011, 11 patients (7 males, 4 females), aged (11.0±2.5) years suffering from femoral primary malignant bone tumors were treated with en bloc excision and reconstruction of the defect with recycled pasteurized autograft. Ten patients were histopathologically diagnosed with high-grade osteosarcoma, and 1 with Ewing's sarcoma.According to the Enneking staging system, all patients were in Stage IIb.
Results: All patients were followed-up for 24-65(42±20) months and all showed bony union at the last follow-up. The length of tumor bone resection was (17.5±3.2) cm, the operation time was (180±35) min, the intraoperative blood loss was (1200±250) mL, and drainage volume was (650±125) mL. Local skin necrosis occurred in 1 patient (9.1%), which was resolved by debridement. Nonunion occurred in 3 patients (27.3%), who were treated by secondary iliac crest cancellous bone grafting.Pulmonary metastasis occurred in 1 patient (9.1%) who died 35 months post-operatively. According to the function assessment by the Enneking system, 5 patients had excellent results, 4 had good results, 1 fair and 1 poor results, with a satisfaction rate of 81.2%.
Conclusion: A pasteurized autograft can be an easily accessible and economical alternative for children's malignant bone tumor of femurs.